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Screening Questions for Length-Dependent SFN vs Non-Length-Dependent SFN

Francis P. Lagattuta, MD (LAGS Spine and SportsCare Med Center, Santa Maria, California); Francis P. Lagattuta, MD; Lane M. Lagattuta, DO; Norma Lagattuta, HT(ASCP)

Meeting: AAPM&R Annual Assembly 2020

Categories: Pain and Spine Medicine (2020)

Session Information

Session Title: Virtual Poster Hall

Session Time: None. Available on demand.

Disclosures: Francis P. Lagattuta, MD: No financial relationships or conflicts of interest

Objective: Small fiber neuropathy (SFN) is relatively new. Usually, large fiber neuropathy is length-dependent (LD), but in one-third of SFN cases, the results show non-length-dependent (NLD) neuropathy, too. We looked to evaluate the symptoms of LD SFN vs. NLD SFN, and identify any possible metabolic risk factors.

Design: Retrospective chart review. Both types of SFN were identified. Before the biopsy, we asked patients if they had: 1. pain, tingling, loss of sensation, burning or weakness in hands/feet? 2. difficulty sleeping because of hand/foot pain? 3. skin dryness in your extremities? 4. dizziness when standing up? 5. loss of balance and coordination? 6. abnormal blood pressure? 7. persistent stomach problems? Patients’ answers were compared between both SFN types. Charts also were reviewed for metabolic conditions. Setting : Outpatient clinic Participants : Patients at an outpatient pain clinic

Interventions: Not applicable

Main Outcome Measures: Comparing percentage of symptoms for LD SFN versus NLD SFN

Results: Out of 1,492 patients, 56 percent had positive responses to one or more of the seven questions. Length-dependent neuropathy patient responses: • pain/tingling (81%) • difficult sleeping (73%) • skin dryness (33%) • dizziness (32%) • loss of balance/coordination (48%) • abnormal BP (29%) • stomach problems (14%) Non-length-dependent patient responses: • pain/tingling (77%) • difficult sleeping (71%) • skin dryness (30%) • dizziness (33%) • loss of balance/coordination (53%) • abnormal BP (39%) • stomach problems (16%) Conclusions: SFN can either be length-dependent or non-length-dependent. There’s no difference in symptoms between LD and NLD SNF. Still to be determined – the physiological differences between LD and NLD SFN, and whether NLD turns into LD SFN.

Level of Evidence: Level IV

To cite this abstract in AMA style:

Lagattuta FP. Screening Questions for Length-Dependent SFN vs Non-Length-Dependent SFN [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/screening-questions-for-length-dependent-sfn-vs-non-length-dependent-sfn/. Accessed May 12, 2025.
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